尿道直肠瘘的外科治疗探讨 (“大家泌尿网”观看手术视频)

Surgical treatment of rectourethral fistula

尿道直肠瘘(RUF)由于其解剖位置的特殊、病情复杂、预后不确定性因素多的特点,成为泌尿外科修复手术的难题之一。近年来,前列腺癌的发生率增高,RUF作为其治疗过程中的严重并发症,发生率也随之增高。RUF的治疗有保守治疗、经腹路径、经会阴路径、经括约肌路径、经肛门路径等多种治疗方法与途径,但目前没有临床共识来指导医生进行选择。近年来,York-Mason及其改良技术应用于RUF的修补,取得较好的治疗结果,本文详细介绍该技术的关键步骤及操作体会。

Rectourethral fistula(RUF)has been difficult to manage in urology due to its special anatomical location,complicated condition and uncertain prognosis.With the increasing incidence of prostate cancer,the incidence of RUF as a serious complication is also rising.Major treatment methods of RUF include conservative treatment and surgical treatment such as transabdominal approach,trans-perineal approach,trans-sphincter approach and trans-anal approach.However,there is no explicit treatment protocol.In recent years,the application of modified York-Mason technique has achieved good results.This article details the key steps and surgical experience of the technique.